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Peri-procedural and mid-term follow-up age-related differences in leadless pacemaker implantation: Insights from a multicenter European registry

2022; Elsevier BV; Volume: 371; Linguagem: Inglês

10.1016/j.ijcard.2022.09.026

1874-1754

Simone Gulletta, Marco Schiavone, Alessio Gasperetti, Alexander Breitenstein, Pietro Palmisano, Gianfranco Mitacchione, Gian–Battista Chierchia, Elisabetta Montemerlo, Giovanni Statuto, Giulia Russo, Michela Casella, Francesco Vitali, Patrizio Mazzone, Daniel Höfer, Gianmarco Arabia, Massimo Moltrasio, Felicia Lipartiti, Nicolai Fierro, Matteo Bertini, Antonio Dello Russo, Ennio Pisanò, Mauro Biffi, Giovanni Rovaris, Carlo de Asmundis, Claudio Tondo, Antonio Curnis, Paolo Della Bella, Ardan M. Saguner, Giovanni B. Forleo,

Atrial Fibrillation Management and Outcomes

Age-related differences on leadless pacemaker (LP) are poorly described. Aim of this study was to compare clinical indications, periprocedural and mid-term device-associated outcomes in a large real-world cohort of LP patients, stratified by age at implantation.Two cohorts of younger and older patients (≤50 and > 50 years old) were retrieved from the iLEAPER registry. The primary outcome was to compare the underlying indication why a LP was preferred over a transvenous PM across the two cohorts. Rates of peri-procedural and mid-term follow-up major complications as well as LP electrical performance were deemed secondary outcomes.1154 patients were enrolled, with younger patients representing 6.2% of the entire cohort. Infective and vascular concerns were the most frequent characteristics that led to a LP implantation in the older cohort (45.8% vs 67.7%, p < 0.001; 4.2% vs 16.4%, p = 0.006), while patient preference was the leading cause to choose a LP in the younger (47.2% vs 5.6%, p < 0.001). Median overall procedural (52 [40-70] vs 50 [40-65] mins) and fluoroscopy time were similar in both groups. 4.3% of patients experienced periprocedural complications, without differences among groups. Threshold values were higher in the younger, both at discharge and at last follow-up (0.63 [0.5-0.9] vs 0.5 [0.38-0-7] V, p = 0.004).When considering LP indications, patient preference was more common in younger, while infective and vascular concerns were more frequent in the older cohort. Rates of device-related complications did not differ significantly. Younger patients tended to have a slightly higher pacing threshold at mid-term follow-up.